Aim: To investigate through a prospective
study the course of migraine with (MA) and without (MO) aura during
pregnancy and postpartum period.

Methods: All pregnant MA or MO sufferers attending
their first routine prenatal examination and who had had at least
one attack during the three months preceding pregnancy were enrolled
and given a headache diary. While attack frequency in the trimester
preceding pregnancy and during the weeks of pregnancy up to the
examination was recorded retrospectively, subsequent attacks were
recorded prospectively at the following examination.

Results: These preliminary data concern 46 women who
have so far completed the study. Of 44 women with MO, a complete
remission was observed in 8.7%, 52.2% and 78.3% in the 1st, 2nd and
3rd trimesters, respectively. Remission or improvement (attack
frequency reduced by at least 50%, or remission) were noted in 56.5%,
82.6% and 87.0% of the patients in the 1st, 2nd and 3rd trimesters,
respectively. No woman worsened. Sixteen women had an attack in
the first week after delivery and 26 in the first month.
Bottle-feeding was a risk factor for an attack during both the
first week and the first month after childbirth. Two women with
MA did not improve.

Conclusions: Pregnancy exerts a very positive effect
on MO, more pronounced during the last two trimesters.
Bottle-feeding is a predictive factor of early recurrence after
delivery.